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Oklahoma rates for HCPCS 21480

Closed treatment of temporomandibular dislocation; initial or subsequent

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$682.00 / $3,683.00 / $7,500.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,383.45 / $5,375.10 / $8,492.60
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$207.85 / $207.85 / $207.85
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$32.86 / $132.05 / $1,145.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$167.81 / $678.00 / $1,582.00